When the Child Becomes the Parent - Part II

Yesterday we began to explore the transition of the adult child as they become the parent to their aging parents.  Today we will continue to explore this transition as it relates to our emotions. I will conclude with some suggestions for self care.

So what about your emotions?  Depending upon the circumstances regarding your parents’ decline, feelings are subjugated to the rational thought required to orchestrate their care. Feelings associated with strength, security, wisdom and parental selflessness that remained unchallenged are forever disrupted precisely when that very support would be most welcomed. In those moments we are required to display those attributes, not in relation to our biological children (we have grown into those roles), but rather for our newly adopted children embodied as our parents!

This situation frequently engenders profound feelings of loss, heightened anxiety regarding our ability to face this impending doom, abandonment, outrage, and helplessness.  No wonder the seemingly easiest path is to deny our feelings and remain focused on the details.  Following the denial path may cause those repressed feelings to manifest as a weakened immune system, as well as a myriad of very real physical complaints. The other possibility is to play out this fear and anger on our parents with lowered frustration tolerance, withdrawal of visits and emotional distancing. 

Our emotional balance must be recalibrated.  That takes time as well as conscious intent, often when we are merely existing rather than living.  If we are aware of our feelings, it may be terrifying to feel the anxiety of anticipatory grief especially when death is not yet imminent.  It is also a struggle between gratefully assuming this new responsibility and needing them to snap out of it and once again take care of you. 

Becoming the parent to our parents is not always as dire as it may seem.  If your parent’s decline is without major crises, there is an opportunity to assume the role with at least their partial approval and perhaps even the full appreciation of your parent.  There is also time to address important emotional issues that may need to be resolved in preparation for their passing.  If your relationship has been solid, there is an opportunity to experience your parent’s fragility and helplessness with the confidence that you will now be their source of security and display your selflessness on their behalf.  They actually have the opportunity to witness the legacy they have spent their lives creating and nurturing come to fruition. 

This is one of those times in life that ongoing professional consultation and/or therapy prove to be an invaluable investment.  Our core beliefs and feelings have been shattered at a time when we must perform consistently and engage effectively.  We are confronted not only with our parents’ mortality but ours as well - in a real and undeniable way.  If you have yet to experience this phenomenon in your life, understand that recognizing your vulnerability will ultimately give you the strength to seek support early in the process so that you can go the distance and become a richer, more improved version of your prior self.  If you have already been through this phenomenon I would challenge you to replay that experience and feel proud and confident that you completed yet another unanticipated stage of life under duress and to the best of your ability!

The Roller Coaster of Grief

In recent posts, I have discussed grief relative to life transitions. Today I would like to discuss bereavement; grief related to loss from death. While you may notice some similarities with burnout and other life transitions, the major difference with death is that there is no opportunity for a second chance. The finality of the experience is undeniable. This grief invades our body, mind and emotions in very real and expected ways and is neither correlated with personal strength nor weakness.

Undoubtedly grief hurts! It can literally take your breath away. Physical symptoms resembling a heart attack are not uncommon and are directly related to the intense anxiety associated with the loss. There are also real physical manifestations that often present as excessive fatigue, malaise, joint pain, gastrointestinal distress, elevated blood pressure, chronic headaches and a suppressed immune system. Have you ever noticed, quite often after the fact that you became ill near important markers such as the deceased’s birthday, one month after their passing or your wedding anniversary? That is no coincidence! Our bodies often serve as channels for our deepest emotions. Sleep (inability to fall asleep and/or remain asleep) as well as appetite impairments are also very common.

Cognitive impairments are also very expected during the grieving process. This may include impaired attention and concentration, obsessive thoughts that focus on the days, hours and minutes that preceded the death and quite the opposite, an impaired memory for details. Quite often, the grief stricken, especially when the loss was sudden, often seems to need to replay the events far too frequently when judged by the casual observer, but the grieving need this because their memories can neither embrace nor retain the reality of their loss. Our minds have a unique protective mechanism that allows only a designated amount of trauma to be absorbed at any given time before it simply shuts down. The extreme cognitive stress that is exhibited is often the result of a combination of emotional, mental and physical exhaustion. Depending on the circumstances surrounding the loss, it may take months for your memory to return to its previous level of functioning.

Emotional reactions to grief can often be characterized as extremes. In the early stages of grief, fear is amplified – fear of forgetting the deceased, fear of being alone, fear of living and a fear of dying. It is not unusual to hear your deceased’s voice, to turn around only to see them, and to experience dreams that feel so real that you dread awakening. Our emotions struggle to keep up with the reality of the recent event. At some point in the grieving process, complete despair is not an uncommon feeling neither is an overwhelming longing to be reunited with your loved one.

Feelings are often experienced in an all or nothing fashion. Along the spectrum of profound sadness, one may display seemingly non-stop crying to a complete inability to cry despite feeling as if it would bring to them a sense of relief. Feelings of apathy (staying in your p.j.’s all day and not getting out of bed) may transform to hyper motivation (cleaning, organizing and completing numerous unfinished tasks often until the wee hours of the morning). Irritability may be displayed as mild frustration (directed at seemingly benign events or individuals) to moderate irritability (rudeness and impatience) to extreme anger (road rage, physical aggression and/or property destruction). It must be noted that these extremes feel and are completely “foreign” to the individual because they did not occur prior to experiencing this loss. Many of my clients have reported feeling “crazy” due to the unpredictability of their responses to the world.

Our previously adaptable coping mechanisms (exercise, social connectedness and engaging in hobbies we once enjoyed) may require far too much energy and therefore are temporarily replaced with maladaptive coping mechanisms that could include an excessive consumption of food, alcohol, prescription drugs, illegal substances and even hyper-sexual behaviors.

The above symptoms seek to illustrate the highly individual and often solitary journey that characterizes grief. The circumstances surrounding the loss often affect and may complicate the grieving process. Complicating factors may be the ages of the deceased as well as the survivors, the suddenness of the loss (anticipated versus untimely and unexpected) and the nature of your relationship with the deceased: was your relationship in emotional order or were there things left unsaid? The specific details surrounding the loss (suicide, homicide, terminal illness or natural causes) as well as the survivor’s loss history (is it the first or fifth and in how many years) may further complicate and extend the grieving process.

So how does does the grieving person effectively tackle their grief? There are numerous theories and published bodies of work authored by thought leaders in this field. The common thread is the notion that grief follows a fairly predictable process from onset to recovery. To work through grief requires moving through these processes and with my clients, often while concurrently redefining themselves. Grief is truly a journey that lasts at the very least one year and more realistically, many years with varying degrees of intensity. Attempting to delay or avoid grieving predisposes the survivor to the possibility that their bereavement and grief develops into a clinical depression, a diagnosable anxiety disorder and/or an identifiable addiction.

When you think of grief as a multiple year journey, how do the survivors gather the initial energy to face it as well as the stamina to go the distance? In the early phases of loss there are close family and friends who rally to support the grieving. Eventually the demands of their own lives split their priorities, and often their support becomes insufficient in meeting the enormity of your need. The option for the grieving at this point is to either become angry when their friend seems to withdraw support or finally reach out for support in the form of individual therapy and/or grief support groups. Ultimately this transition provides an opportunity for your relationship to recalibrate to its previously balanced state.

During my initial session with grieving clients, a visual framework is introduced and as therapy continues, it becomes even more relevant. I equate grieving to riding a roller coaster. What is the first thing you do once you board the roller coaster? You fasten your seat belt! It helps you to stay grounded throughout the ride. Think of therapy as your seat belt on this roller coaster of grief. Just when you think you are once again feeling like your old self, something ignites an emotional spark and down you go. Yet, if you are securely fastened, it is far less scary! The beauty of grief is that with support, you may often climb to heights you never anticipated before the next inevitable dip occurs. At that point you may feel as if your progress has been thwarted, although it quickly resumes when you once again begin the ascent.

Since you can’t avoid the ride, why not step in, fasten your seat belt and hold on for dear life? Your continuing journey through life depends on it…. one step at a time!